You are here

Neonatal Intensive Care (NICU) Research

Body

Neonatal intensive care (NICU) research at CPCE aims to improve the evaluation of neonatal infection risk and to establish appropriate stewardship of antibiotic use.

Over 500,000 newborns are evaluated for risk of neonatal early-onset sepsis (EOS) in the United States each year, with the vast majority ultimately found to be entirely healthy. The most common indication for newborn medical intervention at birth, EOS can significantly impact mother-infant bonding, newborn provider care utilization, and cost of newborn care. Exposure to broad spectrum antibiotics before delivery and within hours of birth can also cause the immune system not to develop to its full potential.

Although the Centers for Disease Control and Prevention (CDC) and the American Academy of Pediatrics (AAP) published guidelines for EOS evaluation, they did not quantify their clinical impact. Through several published studies, we were the first to describe the very high proportion of infants undergoing EOS evaluation, the associated economic costs, and the negative effect on breastfeeding. Our research has helped spark a national debate about the relative merits of EOS evaluation, particularly among low-risk, well-appearing full-term infants.

Research highlights:

In a study published in Pediatrics, CPCE researchers developed and validated a Sepsis Risk Score to estimate individual infant risk and to guide care decisions. This individual risk assessment approach is being incorporated into daily newborn care and has the potential to radically transform the national approach to this increasingly rare but potentially life-threatening condition.

More recently, our research demonstrated that the most predictive information for assessing EOS can be obtained from combining components of the complete blood count (CBC), the most common lab test currently used for this purpose.

A study we published in Hospital Pediatrics found a significant decline in breastfeeding when infants were evaluated for EOS, highlighting the importance of utilizing methods that safely minimize medical intervention.

What’s Next: CPCE researchers are actively working to validate a new prediction model for EOS and plan to investigate the long-term impact of using broad-spectrum antibiotics before delivery or within hours of birth.